后部不同结构切除对胸椎稳定性的影响 - 第三军医大学学报.doc

后部不同结构切除对胸椎稳定性的影响 何 斌，胡侦明，郝 杰，王大武，钟小明 （400016 重庆，重庆医科大学一院骨科）研究后部不同结构胸椎脊柱稳定性。用湿润成人尸体胸椎标本（T7T10），依次T8～9节段进行①单侧关节突半椎板切除；②单侧肋椎关节切除；③后部韧带复合切除体切除，④双侧关节突切除；⑤双侧肋椎关节切除对标本进行。单侧关节突半椎板切除后ROM值无显著性差异（P＞0.05），但双侧小关节突关节切除后，ROM，后部韧带复合体切除后ROM值有显著性差异（P＜0.01），切除双侧肋椎关节后。小关节突关节前屈/后伸和轴向旋转功能稳定性上起到了重要作用单侧小关节突关节及单侧半椎板切除后对稳定性的影响并不显著，后部韧带复合体前屈/后伸时的稳定性起到了控制作用肋椎关节是胸椎脊柱功能单位机械性能中最为重要的后部稳定因素之一。 胸椎；后部不同结构；稳定性Biomechanical Role of the Posterior different structure in the Stability of the Thoracic Spine He Bin, Hu Zhenming *, Hao Jie, Wang Dawu, Zhong Xiaoming (Department of Orthopedics, Affiliated First Hospital of Chongqing Medical University, Chongqing 400016,China) [Abstract] Objectives To investigate the role of the posterior different structure in the stability of the thoracic spine. Methods The thoracic spine specimen of 9 cadaver from T7 to T10, consisting of the sixth to ninth ribs, were used. After testing the intact specimen, resection of the T8-9 posterior stabilizers was conducted incrementally in the following manner: 1) Total unilateral facentectomy with unilateral laminectomy (Group 1), 2) resection of the unilateral costoverebral joint (Group 2), 3) resection of the posterior ligamentous complex with laminectomy (Group 3)，4) bilateral total facetectomy (G4), 5) resection of the bilateral costoverebral joints (Group 5). All specimen were tested in six direction. Paired t-test was used as statistics analysis method. Results Total unilateral facentectomy with unilateral laminectomy did not significantly increase the range of motion in cadaveric thoracic spines (P＞0.05), however, a large increase in the range of motion was observed after bilateral total facetectomy (P＜0.05) and resection of the posterior ligamentous complex with laminectomy in flexion-extension (P＜0.01). A significant increase in the range of motion in flexion-extension, lateral bending and axial rotation was observed after bilateral resection of the costovertebral joints (P＜0.01). Conclusions Total unilateral